Clinical nutritional assessment: a perspective.

The negative implications of hospital malnutrition have been wall documented and demand recognition. Nutritional assessment consists of anthropometric, biochemical, clinical, and dietary indexes and forms the objective basis for diagnosis of protein-calorie malnutrition as well as the mechanism by which nutritional adequacy of aggressive alimentation (enteral and parenteral) is evaluated. In the ideal setting, extensive nutritional assessment consists of numerous tests, measurements, and continuous monitoring performed by a specialist whose primary area of expertise is nutritional assessment and clinical nutritional support. In the absence of this service, significant protein-calorie malnutrition should be suspected if the patient has recently lost weight exceeding 10 per cent of usual weight, has a serum albumin of less than 3.5 gm. per deciliter, or exhibits any pathologic state with nutrition-related manifestations.